Horizontal Inequity in Access to Health Care in Four South American Cities
AbstractResumen El objetivo de este trabajo es analizar el grado de inequidad socioeconómica en el uso de servicios médicos de la población adulta mayor en cinco ciudades latinoamericanas (Buenos Aires, Ciudad de México, Santiago de Chile, San Pablo y Montevideo), en base a los datos de la Encuesta de Salud, Bienestar y Envejecimiento relevada entre 1999 y 2000 (SABE, OPS/OMS, 2001). El análisis imputa el ingreso equivalente del hogar a través de la utilización de las encuestas de hogares de los distintos países, y considerando una amplia serie de indicadores de acceso, calidad y uso de servicios de salud. Una vez estandarizado el uso de servicios por las necesidades de cuidados, se encuentran desigualdades socioeconómicas pro-rico en el uso de servicios preventivos en todas las ciudades, desigualdades en la realización de visitas médicas en Santiago y Montevideo, y desigualdades en la calidad de acceso a la atención en todas las ciudades salvo Montevideo. Las desigualdades socioeconómicas dentro de los sistemas de salud públicos o privados explican una mayor proporción de las desigualdades en el acceso a la atención. Nuestros resultados son informativos en el contexto de las políticas recientes destinadas a la aplicación de paquetes mínimos de servicios. Abstract The objective of this paper is compare socioeconomic inequalities in the use of healthcare services in four South-American cities: Buenos Aires, Santiago, Montevideo, and San Pablo. We use secondary data from SABE, a survey on Health, Well-being and Aging administered in 2000 under the sponsorship of the Panamerican Health Organization, and representative of the elderly population in each of the analyzed cities. We construct concentration indices of access to and quality of healthcare services, and decompose them in socioeconomic, need, and non-need contributors. We assess the weight of each contributor to the overall index and compare indices across cities. Our results show high levels of pro-rich socioeconomic inequities in the use of preventive services in all cities, inequities in medical visits in Santiago and Montevideo, and inequities in quality of access to care in all cities but Montevideo. Socioeconomic inequality within private or public health systems explains a higher portion of inequalities in access to care than the fragmented nature of health systems. Our results are informative given recent policies aimed at enforcing minimum packages of services and given policies exclusively focused on defragmenting health systems.
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Bibliographic InfoArticle provided by UNIVERSIDAD DEL ROSARIO in its journal REVISTA DE ECONOMÍA DEL ROSARIO.
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- Ana I. Balsa & Máximo Rossi & Patricia Triunfo, 2009. "Horizontal inequity in access to health care in four South American cities," Working Papers 131, ECINEQ, Society for the Study of Economic Inequality.
- Ana Balsa & Máximo Rossi & Patricia Triunfo, 2009. "Horizontal Inequity in Access to Health Care in Four South American Cities," Documentos de Trabajo (working papers) 1509, Department of Economics - dECON.
- I1 - Health, Education, and Welfare - - Health
- I11 - Health, Education, and Welfare - - Health - - - Analysis of Health Care Markets
- I12 - Health, Education, and Welfare - - Health - - - Health Production
- I18 - Health, Education, and Welfare - - Health - - - Government Policy; Regulation; Public Health
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